A nurse is admitting an infant who has severe dehydration from acute gastroenteritis. Which of the following findings should the nurse expect?

13% weight loss.

Bulging anterior fontanel.

Bradypnea.

Capillary refill 3 seconds.

Answer and Explanation

The Correct Answer is A

The correct answer is Choice A.

Choice A rationale

A 13% weight loss indicates severe dehydration. Dehydration is classified based on the percentage of body weight lost, with severe dehydration being more than 10%6.

Choice B rationale

A bulging anterior fontanel is a sign of increased intracranial pressure, not dehydration. In dehydration, the fontanel is typically sunken due to fluid loss.

Choice C rationale

Bradypnea, or slow breathing, is not a common sign of dehydration. Dehydration often leads to tachypnea, or rapid breathing, as the body tries to compensate for fluid loss.

Choice D rationale

A capillary refill time of 3 seconds is within normal limits. In severe dehydration, capillary refill time is usually prolonged, indicating poor perfusion.

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Correct Answer is A,B,C,D,E

Explanation

A. Trust vs. mistrust: This stage occurs from birth to 18 months. Infants learn to trust their caregivers to meet their needs. If caregivers are consistent and reliable, infants develop a sense of trust.
B. Autonomy vs. shame and doubt: This stage occurs from 18 months to 3 years. Toddlers learn to do things independently. Success leads to autonomy, while failure results in feelings of shame and doubt.
C. Initiative vs. guilt: This stage occurs from 3 to 5 years. Children begin to assert control and power over their environment. Success leads to a sense of initiative, while failure results in guilt.
D. Industry vs. inferiority: This stage occurs from 6 to 11 years. Children learn to cope with new social and academic demands. Success leads to a sense of competence, while failure results in feelings of inferiority.

E. Identity vs. role confusion: This stage occurs from 12 to 18 years. Adolescents explore their independence and develop a sense of self. Success leads to a strong identity, while failure results in role confusion.

A. A sibling who had a sore throat 3 weeks ago. B. A neighbor’s child who has chickenpox. C. The father who had gastritis 2 weeks ago. D. A classmate who has fifth disease.

Correct Answer is A

Explanation

The correct answer is Choice A.

Choice A rationale

Rheumatic fever is often preceded by a streptococcal infection, such as strep throat. A sibling with a sore throat 3 weeks ago could have had a strep infection, which is a significant risk factor for developing rheumatic fever.

Choice B rationale

Chickenpox is caused by the varicella-zoster virus and is not related to rheumatic fever, which is a complication of streptococcal infections.

Choice C rationale

Gastritis is an inflammation of the stomach lining and is not associated with rheumatic fever.

Choice D rationale

Fifth disease is caused by parvovirus B19 and is not related to rheumatic fever.

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A nurse is admitting an infant who has severe dehydration from acute gastroenteritis. Which of the following findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse has accepted a position on a pediatric unit and is learning about psychosocial development. Organize Erikson’s stages of psychosocial development in order from birth to adolescence.

Correct Answer is A,B,C,D,E

Explanation

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Correct Answer is A

Explanation

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